2015-01-14_HYDROLOGY - C1981035 ‎(3)‎

• Permit No: C1981035
• IBM Index Class Name: Hydrology
• Doc Date: 1/14/2015
• Doc Name: 4th Quarter 2014 Field Well Water Analysis ‎(King I & II Mine)‎
• From: GCC Energy, LLC
• To: DRMS
• Permit Index Doc Type: Other Ground Water
• Email Name: MLT
• Email Name: DIH
• Media Type: D
• Archive: No

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Laboratories
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Address: 4 (.x'73 6 L,2X'
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Phone NumbeA70) X65 tf.S.Z 9A UO3
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CHAIN OF CUSTODY RECORD
NOTES:
I) Ensure proper container packaging.
2) Ship samples promptly following collection
3) Designate Sample Reject Disposition.
PO#
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Table I. – Matrix Type FOR CAL USE ONLY
I = Surface Water, 2 = Ground Water GAL JOB #
3 = Soil /Sediment, 4 = Prod.W., 5 = Oil
6 = Waste, 7 = Other (Specify)
Project Name: %-inC 117x- Samplers Signature:
Lab Name: Green Analytical Laboratories (970) 247 -4220 FAX [phone]
Analyses Required
Address: 75 Suttle Street, Durango, CO 81303 www.greenanalytical.com
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Sample Reject: [ ] Return [ ] Dispose [ ] Store (30 Days)
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